Histological sections, which need to be examined for any length of time or to be stored must be mounted under a cover-slip. There are various types of mounting media available both commercially and also are prepared in one's own laboratory for mounting tissue sections. Some types of mounting media harden to hold the coverslip firmly in place and other types use different solvents such as water, glycerin and xylene because the stains in the sample preparation are sensitive to particular solvent. In order to prevent the of immonoflurescent slides, few mounting media contain antifade reagents. As less emphasis is given in the literature on mounting media, an attempt is made to review, venture and summarize on various types of mounting media and their uses in routine histopathologically and immunochemical staining.

Elements are present in different forms in the nature, and these elements are very essential for the body to perform different functions. Trace elements are very important for cell functions at biological, chemical and molecular levels. These elements mediate vital biochemical reactions by acting as cofactors for many enzymes, as well as act as centers for stabilizing structures of enzymes and proteins. Some of the trace elements control important biological processes by binding to molecules on the receptor site of cell membrane or by alternating the structure of membrane to prevent entry of specific molecules into the cell. The functions of trace elements have a dual role. In normal levels, they are important for stabilization of the cellular structures, but in deficiency states may stimulate alternate pathways and cause diseases. These trace elements have clinical significance and these can be estimated using different analytical method.

Hypothyroid myopathy or Hoffman's syndrome is a rare manifestation of a common condition. It's diagnosis is also difficult. We present a case of Hoffman's disease with predominant proximal myopathy and myotonia.

Homocysteine (Hcy) is a sulfur-containing amino acid with its only source in the human body being methionine. Three B complex vitamins (B 6 , folate or B 9 , and B 12 ) participate in the metabolism of Hcy. Deficiency of these vitamins and the enzymes involved in its metabolism leads to elevated plasma Hcy levels (normal 5 - 15 μmol/l). Hyperhomocysteinemia (HHcy) is associated with several disorders. Hcy levels above 50 μmol/l is thought to be a risk factor for recurrent heart attacks and a value between 150 and 200 μmol/l may cause ischemic stroke. Levels above 300 μmol/l may induce mental deficiency. Several factors contributing to HHcy have been identified. These include lifestyle factors (smoking, alcoholism), drugs (phenytoin, valproate) and genetic causes (cystathionine β synthase deficiency). The various manifestations of HHcy are explained on the basis of oxidative damage and protein homocysteinylation, which cause damage to most tissues/organs leading to health complications and occurrence of various diseases. HHcy may affect major systems in the body like cardiovascular (coronary artery disease, myocardial infarction), central nervous (cerebrovascular accident, Alzheimer's, dementia) skeletal (increased risk of fractures), renal (low GFR), reproductive (risk of infertility), besides increasing the risk of hypothyroidism and cancer. The measures to prevent HHcy include consumption of nutritious foods, lifestyle changes (avoidance of smoking and alcohol) and supplementation of diet with vitamins - B 6 , folate or B 9 , and B 12 .

Introduction: There are about 5 million truck drivers in India. As the eye sight plays a prominent role in safe driving, the truck driver's visual tasks/vision sense needs to be checked periodically.
Aims: The aim of the study was to detect refractive errors and color blindness among truck drivers.
Materials and Methods: We carried out a cross-sectional study on truck drivers. Truck drivers were screened at their resting places after obtaining their prior consent. In our study, we screened 140 truck drivers in various age groups.
Statistical analysis used: We have analyzed the data obtained from the study by using Microsoft Office Excel 2007.
Results: Out of 140 truck drivers screened, the number of truck drivers with visual acuity 6/6 (normal vision) was 100 (71.43%) while the drivers with refractive errors were 40 (28.57%). Of the 40 truck drivers with refractive errors; 11 were having myopia, 20 hypermetropia, and nine were found to have astigmatism. In the entire study, 44 truck drivers were found to have presbyopia. None of the divers had color blindness and/or night blindness.
Conclusions: Most of the truck drivers having defective vision were in the age group of 41-60 years. This indicates that the drivers of this age group should be screened frequently to detect visual defects and they should be encouraged to wear corrective glasses (spectacles) to have normal visual acuity.

Antioxidants (vitamins E and C, β-carotene, superoxide dismutase [SOD], catalase etc.) are the substances that protect cells from the damage caused by free radicals, formed as a result of oxidative stress. Free radicals (O 2− , H 2 O2, OH− , ROO− etc.) are generated during the cellular metabolism and also due to environmental effects (cigarette smoke, ionizing radiations). Excessive production of free radicals has been implicated in the causation and progression of several diseases, e.g., atherosclerosis, cancer, rheumatoid arthritis, diabetes, and cataract. The general belief is that since free radicals are bad for health, antioxidants are good. This led to an indiscriminate use and supplementation of antioxidants, which is currently a controversial issue. This review gives an updated information on the effects of supplementation of antioxidants (vitamins E and C, β-carotene, SOD, catalase etc.). While some studies suggest that antioxidants are beneficial and protective, other interventional trials showed no health benefits. There are some interventional studies which demonstrated the deleterious effects of antioxidants (high risk of cancer, increased mortality). Further, antioxidant supplements were found to diminish the beneficial effects of certain drugs. It is suggested that indiscriminate use of antioxidant supplements should be avoided. Perhaps, antioxidants may be prescribed (not exceeding the recommended daily allowance) to the elderly, strict vegetarians or people who are on calorie-restricted diets. It is advisable that the antioxidants are consumed from rich natural dietary sources rather than supplements. Further, healthy individuals should exercise utmost caution while overdosing themselves with antioxidant supplements.

Background: Alopecias are classified into non-scarring and scarring/cicatricial alopecias. Cicatricial alopecias represent a diverse group of diseases characterized by a lack of follicular ostia and irreversible alopecia. The main purpose of hair revolves around its profound role in social interactions. Loss of hair can lead to significant psychological and emotional distress. Hence, an accurate and early diagnosis and prompt intervention are necessary to prevent further follicular destruction.
Objective: To evaluate the epidemiological, clinical, and histopathological characteristics of various acquired primary cicatricial alopecias.
Materials and Methods: The study population consists of 50 patients with acquired primary cicatricial alopecias seen in our Dermatology Outpatient Department, during the period from September 2008 to September 2010.
Results: The most prevalent diagnoses in order of frequency lichen planopilaris (LPP, 50%), discoid lupus erythematosus (DLE, 20%), and pseudopelade of Brocq (POB, 12%). The ratio of lymphocytic to neutrophilic cicatricial alopecias was 7.3:1. A female predominance of lymphocytic cicatricial alopecias was observed. Both LPP and DLE affected predominantly middle-aged adults.
Conclusion: LPP and DLE followed by pseudopelade were the common cicatricial alopecias. In contrast to the previous large-scale studies, which showed DLE and/or pseudopelade as the foremost diagnosis, LPP is the most frequent cause of adult primary scarring alopecia in our study. An accurate diagnosis of cicatricial alopecia can be achieved only through careful clinicopathologic evaluation. Early scalp biopsy is mandatory in all cases. Further large-scale studies are necessary to establish a cause and pathogenesis behind this increased prevalence of LPP in our setting when compared to the western population.

The relationship between periodontal health and the restoration of teeth is intimate and inseparable. Maintenance of gingival health constitutes one of the keys for longevity of teeth and dental restoration. An adequate understanding of relationship between periodontal tissues and restorative dentistry is paramount to ensure adequate form, function, esthetics, and comfort of the dentition. Despite of an increased emphasis on the perio-restorative interface in restorative dentistry, many clinicians are unable to incorporate the concept of biologic width in a practical manner. This case report presents restorative management of subgingival caries by endodontal and minimally invasive periodontal treatment.

Hair dye poisoning is becoming common in India. Three patients who were admitted into the Emergency Medical Department with a history of ingestion of hair dye available in the market as Supervasmol 33 are presented. Their clinical features, complications, and treatment modalities are discussed and the literature is reviewed.

We report a case of 28-year-old male patient who was run over by train, which resulted in above-elbow amputation on the right side and hand amputation on the left side. His financial status precluded the use of upper limb prosthesis. In this report, we evaluated the various aspects of the Krukenberg operation. The parameters were functionality, stereognosis, cosmesis, dominance, patient and societal acceptance. In our country interest in Krukenburg operation should be rekindled. Most of the surgeons neglected it favor of expensive prosthesis on grounds of unfamiliarity with the surgical procedure.

Cancrum oris or noma is a rapidly spreading gangrenous stomatitis which occurs chiefly in debilitated or malnourished children, destroying the soft and hard tissue structures. Its fulminating course causes progressive and mutilating destruction of the affected tissues. As most patients with noma do not report until the disease is at an advanced stage, its onset and progression still remains a mystery. Survivors of this disease suffer severe facial deformity due to loss of facial tissues and scarring. We report a case report of noma highlighting its onset and progression, the extent of tissue necrosis and its management with an emphasis on the need for early diagnosis and prompt treatment.

Ameloblastomas are usually benign, locally aggressive neoplasms derived from the epithelial odontogenic tissues. The tumors are known for their propensity for local recurrence. Different mechanisms have been proposed to explain the mechanism behind the pathogenesis of ameloblastoma. The proper understanding of the pathogenetic mechanism involved in ameloblastoma and its proliferation, aids in constituting proper treatment. Molecules involved in the pathogenesis can serve as markers in long term follow-up. Expression of the ameloblastin and amelogenin genes in these tumors play a role and they potentiate their action through different mechanisms. This review focuses on the molecular changes that occur in ameloblastoma which has a bearing upon its treatment and prognosis.

Penile fracture is a rare emergent condition, which includes rupture of the tunica albuginea of corpus cavernosum that occurs after trauma to the erect penis. The true incidence of penile fracture is not known as it is rare and under reported entity. Bilateral rupture of tunica albuginea with complete urethral disruption is very rare and very few cases were reported. We report a case of a 46-year-old man who presented with acute pain and swelling of penis and hematuria and severe burning pain during micturition, after a blunt trauma during sexual intercourse. Magnetic resonance imaging (MRI) revealed bilateral rupture in tunica albuginea and complete urethral disruption. We have done emergency repair of tunica and urethra suturing over a catheter. Postoperatively, patient regained normal erectile and voiding functions.

Background: Temporomandibular joint dysfunction (TMJD) is a clinically significant condition which can be a source of acute or chronic orofacial pain and dysfunction including limitation of mandibular movement, pain with mandibular function and joint sounds. Arthrocentesis is joint lavage which washes out these inflammatory mediators, thereby, relieving pain.
Aim: The aim of this study is to evaluate the efficacy of arthrocentesis of temporomandibular joint (TMJ) followed by intra-articular injection of piroxicam in patients with TMJD.
Materials and Methods: Forty TMJ's from thirty patients, aged 18-48 years (mean age 27.33 years) with clinical and radiological diagnosis of TMJD, based on clinical diagnostic criteria (CDC/TMD) were included in the study and underwent arthrocentesis followed by injection of piroxicam. Patient evaluation was done preoperatively and post operatively immediately following the procedure and on 7 th day, 2 nd , 3 rd and 4 th week, 2, 3, 4, 5 and 6 months. Pain on mouth opening on a Visual Analogue Scale (VAS) scale (score 0-10), clicking or popping sounds and maximum mouth opening were recorded at each interval. Magnetic resonance imaging (MRI) was performed before treatment and 6 months after treatment in both groups.
Results: Evaluation of assisted and unassisted mouth opening showed increase at all time intervals. There was significant improvement in pain, range of motion, joint effusion and joint sounds.
Conclusion: Arthrocentesis followed by intra-articular injection of piroxicam is a safe, simple, minimally invasive and effective treatment of temporomandibular joint dysfunction.

Congenital brain anomalies are rare among the congenital anomalies of various organ systems. It is important to diagnose these conditions at the earliest due to its far reaching neurological deficit and detrimental outcome. Most of the congenital brain anomalies can be reliably diagnose by neuroimaging (computed tomography or magnetic resonance imaging) of brain. Radiologist and treating physician should be aware of various specific imaging appearances and unique signs of these anomalies to avoid delay in diagnosis and thereby further treatment. A widely accepted classification of brain anomalies with each representative radiological image are illustrated with its distinctive findings.

Background: Central nervous system tumors which constitute 1-2% of all tumors pose diagnostic challenges because tumors of varying histogenesis show divergent differentiation and overlap in morphological features. In problematic cases, immunohistochemistry is done in addition to the routine histopathologic examination to overcome the diagnostic difficulties, since an accurate histologic diagnosis helps in predicting the clinical outcome of various brain tumors.
Materials and Methods: This study was carried out on a prospective basis in our institution from January 2009 to March 2012. During this period, a total of 246 neurosurgical specimens were received among which 118 brain tumors were diagnosed based on examination of Hematoxylin and Eosin stained sections of formalin-fixed and paraffin-embedded biopsy specimens. Immunohistochemical markers were applied in selective cases for an accurate diagnosis.
Results: In adults, astrocytomas occurred most frequently in the study, followed by meningiomas, nerve sheath tumors, metastatic deposits, glioblastomas, and gliosarcomas. Primitive neurectodermal tumors occurred frequently in children. Other rare tumors included lymphomas and mesenchymal tumors. Age and sex incidence and anatomic distribution of various tumors were studied. Grading of the tumors was done as per the revised World Health Organization criteria. The results of immunohistochemical study in selective cases were analyzed.
Conclusion: This study highlights the utility of immunohistochemistry as an adjunct in the histologic diagnosis of brain tumors in difficult cases.

Aim: To evaluate the quantitative and qualitative changes in cytological buccal smears of type II diabetic patients by using the parameters like nuclear area (NA), cytoplasmic area (CA), and cytoplasmic/nuclear ratio (C/N).
Materials and Methods: The study was done in 40 known type II diabetic patients and 40 healthy individuals. Buccal smears were taken and subjected to Pap-stain. NA and CA of 20 integral cells in the smear were measured using Image Pro-Express Version 6.0 image analysis system by Media Cybernetics Inc., Bethesda, MD, USA. The C/N ratio was then calculated. For comparing cytomorphometric parameters (NA, CA, C/N ratio), t-test was used.
Results: There was a statistically significant increase in average NA and significant decrease in the C/N ratio in diabetics when compared to non-diabetic healthy individuals. The average CA did not show any statistical difference between the two groups. The morphologic alteration seen in diabetic group was the presence of acute inflammation.
Conclusion: Exfoliative cytology is an additional tool to aid in diagnosis of diabetes mellitus, apart from the regular standard tests.

Aim: To analyze the bcl-2 protein expression in the epithelial lining of the Odontogenic keratocyst (OKC), Radicular (RC), and Dentigerous cysts (DC).
Materials and Methods: Forty-five archival samples of paraffin-embedded tissue sections were utilized. Fifteen OKCs, 15 DC, and 15 RC were immunohistochemically analyzed for immunoreactivity of the bcl-2 protein.
Results: Expression of bcl-2 was seen in the basal layer of the epithelial lining of the OKC. DC and RC showed almost complete negativity for bcl-2. There was a statistically significant increased expression in all OKCs.
Conclusion: The bcl-2 protein overexpression could increase the survival of the epithelial cells and this increased lifespan could in turn, lead to the peculiar aggressive growth pattern of OKC. However, the bcl-2 staining can be useful to differentiate OKC from other odontogenic cysts.

Aims:Candida albicans remains the most common species causing human infections but recent epidemiological data reveal shift from C. albicans to non C. albicans species. The aim of our study is to detect the clinical distribution of Candida species in a tertiary hospital.
Materials and Methods: Fifty Candida isolates from clinical samples were studied. The samples were inoculated on Sabouraud's Dextrose Agar (SDA) and Hichrom agar and incubated at 37°C. Growth on SDA were identified and speciated by standard methods. Candida species were identified on Hichrom agar by morphology and color of the colony and were compared with conventional methods. Anti-fungal susceptibility was performed by disc diffusion method using commercially available anti-fungal discs (HiMedia).
Results: Out of 50 Candida isolates collected 62% were from males and 38% from females. The distribution of the clinical samples was urine 44%, exudate 32%, respiratory 14% and blood 10%. C. albicans (54%) was the most common species isolated from these samples. The distribution of non C. albicans were C. tropicalis (18%), -C. krusei (12%), - C. glabrata (10%),- C. rugosa (6%). Among the non-albicans C. tropicalis was seen predominantly in urine and exudates. The specificity and sensitivity of Hichrom agar was 98%. Antibiotic susceptibility pattern shows that about 38% of C. albicans and 17% C. krusei isolates were resistant to fluconazole. Conclusions: Percentage of non-albicans species (46%) are increased in the prevalence with C. albicans (54%) as the predominant species from clinical samples. Anti-fungal profile shows an increased percentage of resistance to fluconazole.

Introduction: Anemia in pregnancy is a ubiquitous problem, more so in the developing countries. Many of the changes that accompany blood loss appear later, rather than sooner, because obstetric patients are usually young fit adults with an expanded blood volume. In such cases, the needs for blood transfusions mainly depend on the clinical condition rather than the preoperative value of the hemoglobin (Hb) and blood loss. This is usually due to the tolerance of these chronic anemia patients to the accompanying blood loss.
Aim: This study was aimed to see how frequently the patients actually received blood perioperatively.
Material and Methods: This was a retrospective analysis of patients who underwent emergency cesarean sections. A total of 303 patients underwent emergency cesareans with Hb <8.5 g% over a period of 18 months in our hospital. These patients divided into three groups based on Hb status, Group I <7 g%, Group II 7-8 g%, and Group III >8 g%. Patients in each group were studied regarding the perioperative blood transfusion, any multiple units received, and complications encountered
Results: In Group I, blood transfusion done in 88% cases fell drastically to 30% in Group II and 20% in Group III. No significant complications were noted and all patients were discharged without any morbidity.
Conclusions: The lower cutoff value of Hb level for an emergency surgery remains a big enigma, which needs further evaluation. Clinical judgment in conjunction with the monitoring of tissue oxygen delivery determines the individual patient's transfusion trigger, and not the use of categorical magic number. Parturient women tend to have lower hematocrit values due to physiological changes and dilutional effect, but they still can tolerate this chronic anemia without any ill effects. This may be one of the reasons for the reduced need for blood transfusion in our study and also for the successful outcome in spite of severe anemia.